title: Objective image analysis of the meibomian gland area.
abstract: OBJECTIVE
  To evaluate objectively the meibomian gland area using newly developed software for non-invasive meibography.
  
  
  METHODS
  Eighty eyelids of 42 patients without meibomian gland loss (meiboscore=0), 105 eyelids of 57 patients with loss of less than one-third total meibomian gland area (meiboscore=1), 13 eyelids of 11 patients with between one-third and two-thirds loss of meibomian gland area (meiboscore=2) and 20 eyelids of 14 patients with two-thirds loss of meibomian gland area (meiboscore=3) were studied. Lid borders were automatically determined. The software evaluated the distribution of the luminance and, by enhancing the contrast and reducing image noise, the meibomian gland area was automatically discriminated. The software calculated the ratio of the total meibomian gland area relative to the total analysis area in all subjects. Repeatability of the software was also evaluated.
  
  
  RESULTS
  The mean ratio of the meibomian gland area to the total analysis area in the upper/lower eyelids was 51.9±5.7%/54.7±5.4% in subjects with a meiboscore of 0, 47.7±6.0%/51.5±5.4% in those with a meiboscore of 1, 32.0±4.4%/37.2±3.5% in those with a meiboscore of 2 and 16.7±6.4%/19.5±5.8% in subjects with a meiboscore of 3.
  
  
  CONCLUSIONS
  The meibomian gland area was objectively evaluated using the developed software. This system could be useful for objectively evaluating the effect of treatment on meibomian gland dysfunction.
authors.affiliation: Department of Ophthalmology, Itoh Clinic, Saitama, Japan Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan Department of Ophthalmology, Keio University, Tokyo, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.affiliation: Eye care company, TOPCON corporation, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Suehiro
authors.affiliation: Eye care company, TOPCON corporation, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Haraguchi
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Shirakawa
authors.affiliation: Eye care company, TOPCON corporation, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tokoro
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging / Q000295:instrumentation* / Q000379:methods; D003941:Diagnostic Techniques, Ophthalmological; D005141:Eyelid Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007259:Infrared Rays; D008297:Male; D008537:Meibomian Glands / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D012984:Software; D055815:Young Adult
keywords: Cornea; Eye Lids; Imaging; Tears